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  • 1.
    Berg, Siv Hilde
    et al.
    Stavanger University Hospital, Norway.
    Akerjordet, Kristin
    University of Stavanger, Norway.
    Ekstedt, Mirjam
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet.
    Aase, Karina
    University of Stavanger, Norway.
    Methodological strategies in resilient health care studies: an integrative review2018In: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 110, no Part A, December, p. 300-312Article, review/survey (Refereed)
    Abstract [en]

    Resilient healthcare research focuses on everyday clinical work and a system’s abilities to adopt or absorb disturbing conditions as opposed to risk management approaches, which are based on retrospective analyses of errors. After more than a decade of theoretical development and a large quantity of empirical work, the field of resilience is beginning to recognize the methodological challenges related to operationalizing and designing studies of complexity. This paper reviews a sample of empirical articles on studies of resilient healthcare to describe and synthesize their methodological strategies. The review found that data collection by resilient healthcare studies has predominantly been conducted at the micro level (e.g. frontline clinical staff). Data sources at the meso level (i.e. hospital/institution) have been limited, and no studies were found that collected macro-level data. We argue that the methodological focus in the field should increase its embrace of complexity and the adaptive capacities of the system as a whole by integrating data sources at the micro, meso, and macro levels. To improve the methodological designs, we argue that the resilience construct, in which the complexity of multiple levels is integrated, must be developed. Improving the transparency and quality of future resilient healthcare research might be accomplished by reporting thorough descriptions of analytical strategies, in-depth descriptions of research design and sampling strategies, and discussing internal and external validity and reflexivity.

  • 2.
    Österman, Cecilia
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    Hult, Carl
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    Praetorius, Gesa
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    Occupational safety and health for service crew on passenger ships2020In: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 121, p. 403-413Article in journal (Refereed)
    Abstract [en]

    The service crew is a vital part of the customer experience on board passenger ships, but also has important duties in the safety organization in case of emergencies. Yet, they are not always recognized as seafarers and have received less attention in research that addresses occupational safety and health in the maritime domain.

    This study explores the occupational safety and health for the service crew working on Swedish passenger ships.The purpose is to analyze causes of work-related ill-health, investigate and identify important aspects of the physical, organizational and social working conditions. The study has adopted a mixed methods approach, including survey questionnaires, register data on reported long-term sick leave, and field visits on board.

    Key findings show that service crew on passenger ships report the highest levels of perceived exertion. They also have the highest rates of long-term sick leave lasting 60 days or more. Most diagnoses are related to musculoskeletal and psychological disorders. Important factors in the shipboard work environment include high physical load and strenuous working postures, poor workplace design, long working hours, limited time for recovery, and the perceived mental and emotional load that comes with unclear boundaries between work and recreation and the social interaction with customers and colleagues. The most prominent health promotive factors to reduce the perceived exertion are appropriate manning, time to rest, working with managers that attend to problems and experiencing good working relations with other departments on board.

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